Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia.
Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Eur J Public Health. 2021 Oct 11;31(4):776-783. doi: 10.1093/eurpub/ckab033.
In Australia, 6.7% of babies (5.2% for singletons) are born low birth weight (LBW), and over the past decade, this figure has increased by 8%. Evidence regarding LBW has largely come from hospital-based cross-sectional studies, which are not representative, lack temporality and do not examine the potential predictors of LBW using a comprehensive theoretical framework. This study, therefore, examined predictors of LBW within a biopsychosocial framework, using a community-based representative prospective cohort with 19 years of data.
The study included 11 854 singleton babies born to 5622 women from the 1973 to 1978 cohort of the Australian Longitudinal Study on Women's Health.
Among 5622 first births, 310 (5.5%) were reported as LBW. Maternal risk factors included pre-pregnancy underweight (aOR = 2.27, 95% CI: 1.43-3.62), chronic diabetes (aOR = 2.38, 95% CI: 1.14-4.95), gestational diabetes (aOR = 1.93, 95% CI: 1.27-2.94), chronic hypertension (aOR = 2.23, 95% CI: 1.50-3.33) and gestational hypertension (aOR = 2.44, 95% CI: 1.78-3.36). Among all births (N = 11 854), the overall LBW rate was 3.8% with a recurrence rate of 4.8%. Identified risk factors included menarche before 12 years (aOR = 1.57; 95% CI: 1.17-2.11), pre-pregnancy underweight (aOR = 2.25, 95% CI: 1.46-3.45), gestational diabetes (aOR = 1.74, 95% CI: 1.16-2.59), chronic hypertension (aOR = 2.01, 95% CI: 1.40-2.90) and gestational hypertension (aOR = 2.81, 95% CI: 2.05-3.84). LBW was less likely for second births (aOR = 0.39, 95% CI: 0.31-0.50) and third/above births (aOR = 0.49, 95% CI: 0.35-0.67) compared with the first births.
Increased nutrition counselling/supplementation for underweight women and interventions aimed at chronic disease prevention and management by using a multi-sectoral approach may be the key to the prevention of LBW.
在澳大利亚，有 6.7%的婴儿（单胎婴儿为 5.2%）出生体重较低（LBW），在过去十年中，这一数字增加了 8%。关于 LBW 的证据主要来自基于医院的横断面研究，这些研究不具有代表性，缺乏时间性，并且没有使用综合理论框架来检查 LBW 的潜在预测因素。因此，本研究在一个身心社会框架内，使用了一个具有 19 年数据的基于社区的代表性前瞻性队列，来研究 LBW 的预测因素。
该研究包括了来自澳大利亚女性健康纵向研究 1973 年至 1978 年队列的 5622 名女性的 11854 名单胎婴儿。
在 5622 次首次分娩中，有 310 次（5.5%）报告为 LBW。母体危险因素包括孕前体重不足（aOR=2.27，95%CI：1.43-3.62）、慢性糖尿病（aOR=2.38，95%CI：1.14-4.95）、妊娠期糖尿病（aOR=1.93，95%CI：1.27-2.94）、慢性高血压（aOR=2.23，95%CI：1.50-3.33）和妊娠期高血压（aOR=2.44，95%CI：1.78-3.36）。在所有分娩中（N=11854），LBW 的总体发生率为 3.8%，复发率为 4.8%。确定的危险因素包括初潮年龄早于 12 岁（aOR=1.57；95%CI：1.17-2.11）、孕前体重不足（aOR=2.25，95%CI：1.46-3.45）、妊娠期糖尿病（aOR=1.74，95%CI：1.16-2.59）、慢性高血压（aOR=2.01，95%CI：1.40-2.90）和妊娠期高血压（aOR=2.81，95%CI：2.05-3.84）。与首次分娩相比，第二次分娩（aOR=0.39，95%CI：0.31-0.50）和第三次及以上分娩（aOR=0.49，95%CI：0.35-0.67）的 LBW 发生率较低。
增加对体重不足的妇女的营养咨询/补充，以及采用多部门方法针对慢性病进行预防和管理的干预措施，可能是预防 LBW 的关键。
